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Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC
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Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Jan 12, 2016

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Page 1: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Journal Club Presentation

APIC Greater NY Chapter 1312.17.14

Faith Skeete, MS RN CIC

Page 2: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Peer Reviewed Journal Article

Page 3: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Main Objective

‘To determine whether preoperative in-room time is a risk factor for surgical site infection (SSI).’

Page 4: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Purpose

To determine whether preoperative in-room time is a risk factor for surgical site infection (SSI).

To determine the threshold time beyond which the infection risk is increased.

Page 5: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Design

Retrospective institutional database review

Page 6: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

MethodsCase finding (2005-2009):

•Review of all consecutive spine surgeries for positive microbiology cultures

•Review of readmissions and reoperations

Page 7: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Methods

CDC SSI definition

Page 8: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Methods

All spine surgeriesn= 9259

All spine surgeries without pre-existing infectionsn= 7991

Page 9: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Methods

Nursing documentation:In-roomIncisionClosureOut-of -room

Page 10: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Methods (Group Comparison)Univariate Analysis Student t test

X2 (Fischer exact test)

Multivariate Analysis:PearsonSpearman

Page 11: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Results

Not infected = 7715

>1hr = 4.9

All cases = 7991

Infected = 276 (rate = 3.4)

<1hr = 2.3

p < 0.001

Page 12: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Results:Predictors of ART

Page 13: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Results:Predictors of ART

Page 14: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Conclusion‘Preoperative in-room time prior to the start of surgical incision is an independent risk factor for SSI.’

Page 15: Journal Club Presentation APIC Greater NY Chapter 13 12.17.14 Faith Skeete, MS RN CIC.

Discussion

Were the results valid?

What were the strengths and weaknesses of the study?

What are the next steps?